• Direct, execute and manage strong relationships with key partners throughout the enterprise to ensure CareSource delivers and meets the specifications of all quality goals/initiatives for products and markets
• Develops, performs and promotes interdepartmental integration and collaboration to enhance LTSS/Dual Program service excellence
• Knowledgeable of state and/or federal regulations, provider agreements and Models of Care for all products/programs and develops structure and process for alignment
• Establish strong operational metrics and auditing to ensure quality and compliance
• Collaborate with market and executive leadership to formulate and implement business strategies and operational plans to ensure core functionality, scalability, and ongoing department management to support LTSS (HCBS and NH) model
• Primary responsibility for translating business and program vision and strategy into operational tactics - collaborating to build the necessary organizational support and infrastructure
• Establish post implementation strategy and goals to mitigate program risks
• Evaluates operational process effectiveness for accomplishing market goals and objectives; manage operation process improvement activities in collaboration with market teams
• Develop, translate, and execute key strategies for functional/ operational requirements
• Provide leadership and support for product expansion
• Incorporates industry standard, best practice project management tools and techniques in market initiatives
• Recognizes and proactively manages operational dependencies and risks across market operations initiatives portfolio through effective change and risk management controls
• Works closely with leadership to establish, communicate, and perpetuate the corporate vision, ensuring appropriate communication to stakeholders
• Monitors performance across markets LTSSS/HCBS programs to leverage best practice and knowledge sharing for the purpose of improving outcomes through the standardization of evidence-based practices
• Assists the dual eligible President with the monitoring of legislative/governmental activities with the goal of advocating for the full integration LTSS/HCBS standard model, identifying opportunities and issues
• Interacts heavily within Dual Eligible, LTSS program business partners, and builds strong working relationships with all markets
• Engages stakeholders to ensure alignment
• Leads activities ensuring the delivery of high quality, consistent initiatives that result in optimum outcomes for members, providers, and program goals
• Recruits, develops, and leads key staff
• Perform any other job related duties as requested.

• Bachelor's degree required
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Eight (8) years of clinical operations/healthcare administration experience required
• Seven (7) years of experience driving performance and process improvements, is in the health care insurance industry required
• Three (3) years of experience with Government-regulated (Federal and/or State) health insurance products including Medicaid, Managed Care Waiver, FFS and Medicare preferred
• Three (3) years of experience implementing programs with focus on integration preferred
• Two (2) years of project management experience required

• Able to effectively identify business problems, assess proposed solutions, and understand the needs of business partners and stakeholders
• Ability to communicate effectively with all levels of leadership
• Develops effective working relationships with business partners and stakeholders
• Strong organizational, time management, analysis, and problem-solving skills
• Ability to manage a project from start to finish
• Strong relationship building skills and leadership qualities
• Training and teaching skills/change agent
• Ability to think critically and lead with strategy
• Comprehensive knowledge base crossing all the following areas: Clinical Operations, Market Groups, Business Development, Network, and Operations
• Hands on proficiency in Microsoft Office tools, including Project, Outlook, Word, PowerPoint, and Excel
• Business acumen and politically astute ability to act with diplomacy and sensitivity to cultural diversity

• None

• General office environment; may be required to sit or stand for extended periods of time
• Up to 15% (occasional) travel based on the needs of the department may be required

Compensation range $150,000-$300,000.  CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Energize and Inspire the Organization

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.